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What condition is characterized by negative scotomas and a pale optic disc with cupping?
Which of the following is NOT a feature of stage 1 diabetic retinopathy?
What are soft exudates in the context of retinal pathology?
What condition can lead to indistinct disc margins and optic disc edema due to increased intraocular pressure?
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During stage 2 of diabetic retinopathy, which of the following findings is an indicator of more severe pathology?
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What is a significant consequence of retinal vein occlusion lasting more than one hour?
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Which of the following is primarily associated with the development of diabetic retinopathy?
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Which symptom is indicative of hypertensive retinopathy?
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What does the presence of copper-silver wiring in retinal blood vessels indicate?
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Which of the following conditions is considered a prevalent cause of preventable blindness?
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What visual symptom is most characteristic of cataracts?
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What is a common risk factor contributing to the development of chronic glaucoma?
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Which diagnostic sign would suggest a retinal condition requiring emergency referral?
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What is the primary treatment for neovascularization near the optic disc in diabetic patients?
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In which type of diabetes is it crucial to start ophthalmologic exams within the first 5 years of diagnosis?
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What does the presence of drusen indicate in macular degeneration?
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What would you expect in a Weber test for a person with conductive hearing loss?
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Which of the following statements is true regarding sensorineural hearing loss as indicated by the Rinne test?
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What is the most common cause of sensorineural hearing loss?
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What symptom would suggest a patient has macular degeneration affecting their central field of vision?
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How does conductive hearing loss differ from sensorineural hearing loss in terms of sound conduction channels?
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What is the recommended first-line antibiotic for the treatment of uncomplicated otitis media?
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Which of the following ear findings is typically associated with tympanic membrane (TM) changes in otitis media?
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In infants aged 8 weeks or under, what fever temperature is concerning and necessitates ruling out serious conditions such as sepsis and meningitis?
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Which factor is NOT considered a risk factor for recurring otitis media in infants?
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What is a common complication associated with a ruptured tympanic membrane in the context of otitis media?
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What is the primary cause of vestibular neuronitis?
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Which characteristic is NOT associated with peripheral nystagmus?
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What is the most typical presentation of vestibular neuronitis in terms of vertigo episodes after the first attack?
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In which age group is vestibular neuronitis most commonly seen?
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What type of nystagmus is characterized by movements that go away within one minute and show latency?
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Which of the following tests is used to assess the balance of patients suspected of having vestibular issues?
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What should be considered if a central cause of vertigo is suspected?
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What symptom is typically NOT experienced by patients with vestibular neuronitis?
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Study Notes
Retinopathy
- Retinopathy is damage to the retina, the light-sensitive tissue at the back of the eye.
- Retinopathy can cause vision loss and blindness if untreated.
- Common causes of retinopathy include hypertension, increased blood viscosity, diabetes, and chronic obstructive pulmonary disease (COPD).
- Symptoms of retinopathy can include blurred vision, floaters, flashing lights, and a loss of central vision.
- A cherry red spot on the macula indicates a retinal occlusion.
- If an occlusion lasts longer than an hour, it can lead to optic nerve atrophy.
- Treatment for retinopathy depends on the severity of the condition and may include laser surgery or medications.
Blood Thunder
- Blood Thunder refers to a sudden and dramatic increase in blood pressure, often accompanied by a headache, dizziness, and nausea.
- It is a rare but serious condition that can lead to a stroke or other serious complications if not treated.
- Blood Thunder is often associated with preeclampsia, a dangerous condition that can develop during pregnancy.
Central Retinal Vein Occlusion (CRVO)
- CRVO causes gradual vision loss.
- CRVO is more common than acute vision loss.
- Caused by a blockage of the central retinal vein, which carries blood away from the retina.
- Symptoms include blurred vision, floaters, and a loss of central vision.
- There is a pale optic disc with cupping.
Cataracts
- Cataracts are a clouding of the natural lens of the eye.
- Cataracts are a common age-related condition.
- Cataracts can also be caused by diabetes, smoking, and exposure to ultraviolet radiation.
- Symptoms of cataracts include blurred vision, halos around lights, and difficulty seeing at night.
- Treatment for cataracts involves surgery to remove the clouded lens and replace it with an artificial lens.
Chronic Glaucoma (Open Angle)
- Characterized by a gradual increase in intraocular pressure (IOP), which damages the optic nerve.
- Damage to the optic nerve can lead to peripheral vision loss.
- Over time, glaucoma can progress and cause blindness.
- Often no symptoms until advanced stages, leading to undetected damage.
- Risk factors include age, family history, and diabetes.
- Treatment includes medications to lower IOP, laser surgery to increase drainage, and surgical procedures to improve drainage.
Diabetic Retinopathy
- Diabetic Retinopathy results from damage to the blood vessels in the retina caused by diabetes.
- Early stages do not produce symptoms.
- Advanced stages cause vision loss or blindness.
- It is the leading cause of preventable blindness in adults with diabetes.
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Nonproliferative Diabetic Retinopathy - stage 1
- Decreased circulation with endothelial damage
- Retinal ischemia occurs
- Microaneurysms develop and rupture - creates superficial flame hemorrhages and deeper blot hemorrhages
- Soft exudates (caused by leakage of proteinaceous material) and hard exudates (fatty deposits on the retina)
- Cotton wool spots (caused by nerve fiber ischemia)
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Proliferative Diabetic Retinopathy - stage 2
- Same findings as stage 1, but more severe
- Neovascularization (growth of new blood vessels) near the optic disc
- New vessels bleed easily and can lead to a retinal detachment
Hypertensive Retinopathy
- Hypertensive Retinopathy results from damage to the blood vessels in the retina caused by high blood pressure.
- Copper-silver wiring of the arterial wall on the retina due to engorged blood vessels
- Arteriovenous (A/V) nicking due to thickened arterial walls
- Flame hemorrhages and soft exudates
- Optic disc edema (indistinct disc margins)
- Optic disc can be several times larger - can also happen with a brain tumor (papilledema) due to increased IOP
Macular Degeneration (Senile)
- Macular Degeneration primarily affects central vision, making it difficult to read, drive, or recognize faces.
- Usually affects both eyes.
- Characterized by a pigmented macula, exudates, and drusen appearance.
- Treatment options include laser surgery and medications.
Types of Hearing Loss
- Conductive Hearing Loss - originates from the outer or middle ear, causing sound to not reach the inner ear properly.
- Sensorineural Hearing Loss - originates from the inner ear or the auditory nerve, causing damage to the sensory receptors or nerve pathways.
Weber Test
- Assesses bone conduction.
- A tuning fork is held on the top of the head to determine if sound is louder in one ear than the other.
- Conductive hearing loss: sound lateralizes to the affected ear (bc no air conduction, only bone).
- Sensorineural hearing loss: sound lateralizes to the unaffected ear (bc the good nerve is intact).
Rinne Test
- Compares air conduction (AC) and bone conduction (BC).
- A tuning fork is placed on the mastoid bone (BC) and then moved to the ear canal (AC).
- Normal: AC > BC
- Conductive Hearing Loss: BC > AC
- Sensorineural Hearing Loss: AC > BC
Etiologies of Hearing Loss
- Presbycusis: Age-related, common cause of sensorineural hearing loss.
- Noise Exposure: Prolonged exposure to loud noises can damage the delicate inner ear.
Vestibular Neuronitis
- Definition: Inflammation of the vestibular division of the eighth cranial nerve (CN VIII), usually viral.
- Incidence: Common, usually affects people between 30-40 years old.
- Symptoms: Abrupt onset of debilitating vertigo, usually unidirectional horizontal nystagmus.
- First Attack: Usually most severe and typically recurrent.
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Nystagmus:
- Peripheral: Latency, fatiguing, unidirectional, ameliorated by gaze fixation.
- Central: No latency, no fatigue, multidirectional, exacerbated by gaze fixation.
Vestibular Migraine
- Definition: Migraine headaches with a sudden onset of dizziness or vertigo.
- Symptoms: Vertigo, headache, nausea, vomiting, sensitivity to light and sound, visual disturbances.
- Diagnosis: Based on clinical presentation, history, and neurological examination.
Otitis Media (OM)
- Definition: Inflammation of the middle ear characterized by ear pain, fever, and hearing loss.
- Risk Factors: Daycare attendance, exposure to smoke, family history of recurrent OM.
- Ear Findings: Red tympanic membrane (TM), decreased light reflex, thickened TM, bulging of TM, drainage
- Causes: Bacterial infections (Strep pneumoniae, H. influenza, Moraxella catarrhalis)
- Treatment: Amoxicillin is the antibiotic of choice for initial and uncomplicated OM.
- Signs of Severity: infants < 6 months, toxic appearing (severe pain, fever, decreased feeding).
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Description
This quiz explores the conditions of retinopathy and Blood Thunder, highlighting their causes, symptoms, and potential treatments. Learn how these serious health issues can affect vision and overall well-being. Gain insights into their management and the importance of timely intervention.